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10.4 Preparing for ECG Monitoring
10.4.1 Preparing the Patient Skin
Proper skin preparation is necessary to ensure good signal quality at the electrode sites, as the skin is a poor
conductor of electricity. To properly prepare the skin, choose flat areas and then follow this procedure:
1. Shave hair from skin at chosen electrode sites.
2. Gently rub skin surface at sites to remove dead skin cells.
3. Thoroughly cleanse the site with a mild soap and water solution.
4. Dry the skin completely before applying electrodes.
10.4.2 Applying Electrodes
To connect ECG cables, follow this procedure:
1. Check that electrode packages are intact and the electrodes are not past the expiry date. Make sure the
electrode gel is moist. If you are using snap electrodes, attach the snaps to the electrodes before placing
electrodes on the patient.
2. Place the electrodes on the prepared sites. Make sure that all electrodes have good skin contact.
3. Connect the leadwires to the patient cable if not already connected.
4. Plug the patient cable into the ECG connector.
• Store the electrodes at room temperature.
• Only open the electrode package immediately prior to use.
• Never mix patient electrode types or brands. This may lead to problem due to impedance mismatch.
• When applying the electrodes, avoid bony area, obvious layers of fat, and major muscles. Muscle
movement can result in electrical interference. Applying electrodes on major muscles, for example
on muscles of the thorax, may lead to erroneous arrhythmia alarms due to excessive muscle
movement.
10.4.3 Lead Wire Color Code
The following table lists the color coding of leadwires for both AHA and IEC standards:
Lead
IEC AHA
Label Color Label Color
Right arm R Red RA White
Left arm L Yellow LA Black
Right leg (neutral) N Black RL Green
Left leg F Green LL Red
Chest 1 C1 White/Red V1 Brown/Red
Chest 2 C2 White/Yellow V2 Brown/Yellow
Chest 3 C3 White/Green V3 Brown/Green
Chest 4 C4 White/Brown V4 Brown/Blue
Chest 5 C5 White/Black V5 Brown/Orange
Chest 6 C6 White/Violet V6 Brown/Violet
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